How Tristan Roberts Was Cured of HIV
A necessary cancer treatment offered a rare opportunity to cure one man of HIV. Learn how specific genetics made this possible and what it means for medical science.
Tristan Roberts, once known as the “London Patient,” is one of a very small number of individuals functionally cured of the Human Immunodeficiency Virus (HIV). His journey resulted from a convergence of dire medical needs and a unique therapeutic strategy. This outcome has fueled both scientific discussion and public hope regarding the future of HIV treatment.
The Dual Diagnosis
Tristan Roberts was diagnosed with HIV in 2003. He began antiretroviral therapy (ART), which effectively suppressed the virus and controlled his viral load for many years. A new health challenge emerged in 2012 when he was diagnosed with an advanced stage of Hodgkin’s lymphoma, a type of blood cancer. The cancer proved aggressive, and after various chemotherapy treatments, it became clear a more radical approach was necessary. This diagnosis created the medical context to consider a procedure to treat the lymphoma and the HIV infection.
The Groundbreaking Treatment
The proposed treatment was an allogeneic hematopoietic stem cell transplant, which replaces a patient’s immune system with a donor’s. It is an intensive and high-risk intervention, typically reserved for patients with severe blood cancers who have exhausted other options. The unique aspect of his treatment was the selection of the stem cell donor. Researchers sought a donor with a rare genetic mutation known as CCR5-delta 32. This mutation removes the CCR5 co-receptor from immune cells, the primary entry point most strains of HIV use to infect cells.
The medical team located a compatible donor who was homozygous for this mutation, meaning they inherited it from both parents. Roberts was infused with stem cells that would build a new immune system naturally resistant to his strain of HIV. After the transplant, he remained on ART for a period before treatment was stopped. Thirty months after discontinuing the medication, his HIV viral load remained undetectable, leading to his long-term remission.
Life After the Cure and Advocacy
After years of anonymity, Tristan Roberts revealed his identity in 2020. He shares his story to be a source of hope and an advocate for advancing cure-focused research, speaking at conferences to share his medical journey.
His case provided data for the scientific community, demonstrating that a cure is possible under specific circumstances. The success of this procedure in another patient, after the “Berlin Patient,” confirmed the outcome was not an isolated anomaly. It has reinforced the CCR5 pathway as a target for gene therapies and other cure strategies.
This procedure is not a viable cure for the vast majority of people living with HIV. Stem cell transplants carry substantial risks, including graft-versus-host disease, where the donor’s immune cells attack the recipient’s body, and have a high mortality rate. The intensive chemotherapy required to prepare the body for the transplant is highly toxic. For these reasons, this approach is only considered for individuals who have a life-threatening cancer that requires such a transplant.